What is an ankle sprain?Ligaments help stabilise the ankle joint and prevent excess motion. Ankle injuries occur when ligaments are stretched beyond their normal range of motion and the ankle moves in an awkward motion beyond the normal range of that joint. The most common mechanism of ankle sprain is a combination of plantarflexion and inversion, or a downward-inward motion of the foot about the ankle.
When this takes place, the 3 main outer ankle ligaments stretch or tear depending on the severity. With severe ankle injuries, fractures and joint displacement can occur.
Ankle sprains are graded based on the severity and degree of ligamentous injury.
Grade 1: Partial tear of a ligament
Grade 2: Incomplete tear of a ligament with moderate functional impairment
Grade 3: Complete tear and loss of integrity of a ligament
What are the symptoms of an ankle sprain?Ankle sprains present with pain to the outer ankle area. Redness and swelling may occur. There will be pain and tenderness on palpation, weight bearing, and joint motion. Range of motion of the ankle and foot will also be limited.
How is an ankle sprain diagnosed?Ankle sprains are evaluated with a careful history and thorough physical examination. In conjunction with a good history and physical examination your Podiatrist may refer you to have a X-Rays to rule out any bone injury or a ultrasound evaluation of the ligaments and tendons which allows for visualisation of any soft tissue pathology. For severe ankle trauma, or when conservative therapy is not effective your podiatrist will refer you on to a Consultant Podiatric Surgeon or Consultant Orthopaedic Surgeon as a CT or MRI scan will be required to allow for proper visualisation of both bone and soft tissue allowing for the proper treatment course to be implemented.
How do you treat an ankle sprain?Treatment of ankle injuries depends on the extent of the injury. This is where a proper grading of the injury dictates the best treatment course of action.
- Mild or Grade 1 Ankle Injuries: Early management via Rest, Ice, Compression, and Elevation. Limiting physical activity. Non-steroidal anti-inflammatory drugs can help alleviate the pain and reduce swelling.
- Moderate or Grade 2 Ankle Injuries: Same as a grade 1 injury with the addition of a supportive device such as an elastic bandage, ankle stabilizer, or air cast.
- Severe or Grade 3 Ankle Injuries: Further immobilisation or offloading of the ankle joint may be necessary. This can be accomplished with the use of a removable walking boot with the addition of crutches to assist with ambulation. Rarely, but still possible, does an ankle sprain require surgical intervention.